Early Signs of Dementia

Some people, as they get older, might have some “brain changes".” They might ask a question a few times, miss-tell a story, or forget a doctor's appointment. These moments of forgetfulness can be scary for their children, friends, and most importantly, themselves. These moments might make you think “Do I have Dementia or Alzheimers?”

In this article, I am going to break down aspects of memory impairments to watch out for, what you can do as a support person, and if a cognitive assessment might be needed. To preface, I am not a doctor and this article gives great information but is not a formal diagnosis!

Early Stages of Dementia

When talking about memory impairment in older adults, it is important to note that not all changes are definitively dementia. Some are basic age related changes the brain goes through over time. Some people refer to this as “age brain.” You may lose some sharpness, critical thinking abilities, and have to remind yourself a few times about activities or memories. Dementia, in turn, is an abnormal change to the brain. It is not part of the normal aging process, hence why dementia, Alzhiemers, lewy-body dementia, and vascular dementia are considered diseases. 

Let's take my Grandfather for example. He is nearly 90 years old and independent. He would have what I consider “age brain.” He sometimes will mix up foods when going to the grocery store for my Grandmother. I may tell him a story, and he can retell it somewhat incorrectly. He also may ask a question a few times (which can also be related to his hearing). Yet, he still rides his bike 10 miles every day and knows his little town like the back of his hand. He also never misses a day to fish. He can make food (basic food) by himself, and still helps my grandmother to garden. He mixes up people in his head, but most of the time can retell moments of his life without a hitch. Last time I talked to him, he said “Hell, I do not know what is going on half the time!” My Grandfather is showing slight changes in his memory and cognitive ability. It is not drastic, and has happened slowly over time. Some people might mistake his cognitive level for dementia. 

If your parent has dementia, there are a few big changes we notice in the beginning stages: 

Repetitive Questions

Repetitive questions can be a beginning sign of dementia. You might be confused, as I also said this can be common with normal “age brain.” Repetitive questions by itself do not always mean dementia. But, partnered with other signs below, it can be an indicator. 

An example of repetitive questions can be in regards to many things. Most common is asking the time or time related questions. This can be asking when the next meal is going to be served, the time of a doctor's appointment, or the time an activity is planned. Time can cause a lot of anxiety. They can be worried about missing an appointment or getting together with friends.  They might have missed a few in the past, and are worried about missing more in the future. 

Another example is asking about names. With dementia, individuals can slowly lose the ability to put faces to names and even might mix people up. For example, my Grandmother with Dementia used to call me my Mother’s name. 

The last example I want to touch on is asking questions about a conversation. You may have had incidents where you discussed something with your parents. After the discussion, they began asking “re-affirming” questions. For example, you had a discussion about finances and they asked you a question about their bank a few times, or the amount of money in the bank account a few times. 

Increased Isolation

Another possible sign is increased Isolation. In early stages of dementia, individuals can begin to isolate themselves. They do not like leaving their home or venturing to new places. They may cancel on plans or not make plans with family or friends. One of the biggest reasons is they are embarrassed of their “deficit.” I had one client who never wanted to reach out to friends. This client was very social in the past and was a member of many community groups. When the client received the diagnosis of Dementia, the client was worried the friend group would notice. It is important to encourage your parents/friend/family to continue socializing! Re-assure them that no one is going to judge their diagnosis! 

Refuses

Increased refusal is also a sign. Refusing can span many aspects of one's life. It can be in regards to refusing to go out and do activities, refusing to talk to new people, refusal to care, etc. They might also start “refusing” to do activities they once enjoyed. There are many reasons for that. It could be because they no longer know how to do it, or are scared of others seeing them “struggle.” 

If your loved one is refusing important things like doctors appointments or foods, it is important to share with them why they should do it. Never raise your voice or put the blame on them. Be calm, and explain why these aspects of life should not be neglected. 

Change in behavior

A change in behavior can also be noted. Dementia can cause a wide array of behavioral changes. Someone who could have been mild-mannered before could be quick with their words and get upset easily. Someone who once had a “big personality” could become more quiet and reserved. 

The part of the brain that regulates behaviors and emotional responses does not work as well when someone gets dementia. Things that once did not bother them, could now. Paranoia and hallucinations could also occur. One of the most common forms of paranoia for early stages of dementia is “Someone stole XYZ.” With the difficulty of remembering where certain objects are, when something can not be found, they might believe it was stolen. 

How they refer to someone can also change. I have noticed a lot of “Main caregivers” being referred to as Mom or a name similar to that. These “Main Caregivers” are prominent friends of family such as a daughter or a wife. This occurs because in their mind a mother figure is someone who takes care of them. They perceive this family member taking care of them, but can have the difficulty separating designation of people in their life. 

Language 

Language understanding also ties into the “Mom/Caregiver” mix-up. Language Understanding and Vocalizing Language can be altered. Someone with dementia might not be able to produce the right words. They may know that their primary caregiver is not their mother, but is unable to find a word that describes them. They also can have difficulty taking in vocabulary. They might perceive what you said incorrectly or not understand it at all. That is why it is important to talk slowly and clearly. If needed, repeat your words a few times. 

Conclusion

These signs are only a few of many that can indicate possible memory impairment. These signs are the most common ones in my years of experience. If you are wondering if your parents/friend/or family have dementia, please contact your doctor!